Hi, Thank you for your query. I can understand your concerns. The symptoms of Serotonin syndromeare is often described as a clinical triad of abnormalities: Cognitive effects: headache, agitation, hypomania, mental confusion, hallucinations, coma Autonomic effects: shivering, sweating, hyperthermia, vasoconstriction, tachycardia, nausea, diarrhea. Somatic effects: myoclonus (muscle twitching), hyperreflexia (manifested by clonus), tremor. There is no laboratory test for serotonin syndrome. Therefore diagnosis is by symptom observation and investigation of the patient s history. You have some of the symptoms. However physical examination of the patient is also required including assessment of deep-tendon reflexes and muscle rigidity, the dryness of the oral mucosa, the size and reactivity of the pupils, the intensity of bowel sounds, skin color, and the presence or absence of sweating. Management is based primarily on stopping the usage of the precipitating drugs, the administration of serotonin antagonists such as cyproheptadine, and supportive care including the control of agitation, the control of autonomic instability. Regards Dr. T.K. Biswas M.D. Mumbai